Search Our Scientific Publications & Authors

J Chin Med Assoc 2022 May 2. Epub 2022 May 2.

Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC.

Obstructive sleep apnea (OSA) is characterized by partial or complete airway blockage during sleep. Nocturnal nasal obstruction usually leads to mouth breathing while sleeping, which worsens sleep apnea by aggravating tongue base and lateral pharyngeal wall collapse. The pathogenesis of OSA is multifactorial, and the precipitating factors vary significantly among individuals. Read More

Sleep Med 2022 Apr 1;94:76-83. Epub 2022 Apr 1.

Department of Neurology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong, China. Electronic address:

Objective: The purpose of our study was to investigate the correlation between neural-derived plasma exosomal amyloid-β (Aβ)42, total tau (T-tau) and tau phosphorylated at threonine 181 (P-T181-tau) protein levels and cognitive impairment in patients with obstructive sleep apnea (OSA).

Methods: There were 122 subjects without dementia included in the study: 27 patients with OSA and mild cognitive impairment (MCI), 52 OSA patients without MCI, and 43 subjects diagnosed with simple snoring but not MCI as the control group. Neuronal-derived exosomal proteins were measured by ELISA kits for Aβ42, T-tau and P-T181-tau. Read More

Sleep Sci 2022 Apr-Jun;15(Spec 2):398-405

Sleep Unit, Centro Cardiovascular da Universidade de Lisboa, Lisbon School of Medicine, Lisbon, Portugal.

Obstructive sleep apnea (OSA) is the most prevalent sleep-disordered breathing in the adult population and if untreated remains a significant cause of morbidity and mortality. Continuous positive airway pressure (CPAP) therapy is still the gold standard treatment for OSA, but patient acceptance and adherence are often poor due to a multitude of factors, thereby compromising treatment success. Mandibular advancement devices (MADs) have been proposed not only as a first line therapy for symptomatic snoring patients, but also for those suffering from mild to moderate OSA, or those who refuse or do not tolerate CPAP. Read More

J Pers Med 2022 Mar 16;12(3). Epub 2022 Mar 16.

Department of Orthodontics, School of Dentistry, National and Kapodistrian, University of Athens, 157 72 Athens, Greece.

Background: Mandibular advancement devices for obstructive sleep apnea treatment are becoming increasingly popular among patients who do not prefer CPAP devices or surgery. Our study aims to evaluate the literature regarding potential dental and skeletal side effects caused by mandibular advancement appliances used for adult OSA treatment.

Methods: Electronic databases were searched for published and unpublished literature along with the reference lists of the eligible studies. Read More

Sleep Sci 2022 Jan-Mar;15(Spec 1):135-142

Universidade Federal de Minas Gerais, Faculty of Dentistry, Belo Horizonte, Brazil, - Belo Horizonte - Minas Gerais - Brazil.

Aims: A cross-sectional study was designed to evaluate the effectiveness of a mandibular advancement device (MAD) with respect to respiratory and sleep parameters among miners with obstructive sleep apnea syndrome (OSAS) and primary snore.

Methods: The target sample was composed by 102 Brazilian miners with a history of non-adherence to continuous positive airway pressure. All patients were treated with a MAD and underwent pre and post-treatment full-night polysomnography. Read More

Respir Med Case Rep 2022 18;36:101602. Epub 2022 Feb 18.

Division of Pulmonary and Sleep Disease, Lebanese American University- Medical Center, Lebanon.

Ehlers-Danlos Syndrome (EDS) is a group of rare connective tissue disorders characterized by genetic defects in collagen and connective tissue synthesis and structure, with manifestations ranging from asymptomatic or mild skin and joint hyperlaxity to severe physical disability. Mild asymptomatic forms of Ehlers-Danlos syndrome seems to be under diagnosed and may have severe systemic complications mainly cardio vascular. Cartilaginous defects in the head and neck region increase the risk of Sleep-Disordered Breathing (SDB) especially Obstructive Sleep Apnea (OSA). Read More

Eur Arch Otorhinolaryngol 2022 Feb 6. Epub 2022 Feb 6.

School of Medicine, Campus Bio-Medico University, Unit of Integrated Therapies in Otolaryngology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy, Via Alvaro del Portillo 21, 00128, Rome, Italy.

Introduction: Oropharyngeal surgery for Obstructive Sleep Apnea (OSA) has evolved from a radical excision of "redundant" soft tissue for the enlargment of the airway to a minimally invasive reconstruction to fulfill both preservation of pharyngeal function and improvement of sleep apnea. Recently, Alianza surgical technique has been successfully introduced as a new, non-resective procedure aimed to treat concentric pharyngeal collapse at the velum using Barbed Sutures. The aim of this study was to show the effectiveness and safety of Alianza technique as standalone surgical treatment in selected patients with moderate-severe OSA and concentric pharyngeal collapse that refused or did not tolerate Continuous Positive Airway Pressure therapy. Read More

Sleep Med 2022 01 24;89:71-77. Epub 2021 Nov 24.

University of Missouri School of Medicine, Department of Child Health, Columbia, MO, USA.

Study Objective: There is very limited information about the effect of continuous positive airway pressure (CPAP) in the very elderly. Here we aimed to analysed the effect of CPAP on a clinical cohort of patients with obstructive sleep apnea (OSA) ≥80 years old.

Methods: Post-hoc pooled analysis of two open-label, multicenter clinical trials aimed to determine the effect of CPAP in a consecutive clinical cohort of elderly (≥70 years old) with moderate-to-severe OSA (apnea-hipopnea index ≥15 events/hour) randomized to receive CPAP or no CPAP for three months. Read More

Saudi Dent J 2021 Nov 26;33(7):424-433. Epub 2021 Feb 26.

Eastman Institute for Oral Health, 625 Elmwood Ave, Rochester, NY 14620, USA.

The objective of this article is to review the role of the dentist in the early diagnosis of pediatric obstructive sleep apnea (OSA) and to provide an in-depth review of the best evidence-based practices available to treat and/or to refer these patients for intervention.

Material And Methods: A narrative review was performed using indexed data bases (PubMed, Medline, EMBASE, OVID, Scopus and Cochrane) up to year 2020, and approximately 1000 articles were reviewed. The articles included were those with the best information provided. Read More

Nat Sci Sleep 2021 15;13:1877-1885. Epub 2021 Oct 15.

Department of Otolaryngology-Head and Neck Surgery, Sleep Center, Chang Gung Memorial Hospital (Linkou), Taoyuan City, Taiwan.

Purpose: Obstructive sleep apnea (OSA) is characterized by recurring hypoxic-apneic events during sleep, and labyrinthine vascular compromise is a pathophysiologic hallmark of idiopathic sudden sensorineural hearing loss (ISSNHL). Some reports have discussed the relationship between OSA and hearing impairment; however, few have examined hearing prognosis in OSA and patients without OSA with ISSNHL. We aimed to investigate clinical manifestations of ISSNHL in patients with OSA, including severity of hearing loss and response to treatment. Read More

Schizophr Bull 2022 03;48(2):437-446

School of Psychological Science, University of Western Australia, Perth, Australia.

Obstructive sleep apnea (OSA) is a highly prevalent condition in people living with schizophrenia or other psychotic disorder. Its treatment with continuous positive airway pressure therapy (CPAP) can dramatically improve daytime and physical health function. People with a psychotic disorder, however, are rarely diagnosed and treated and there are no large-scale studies showing evidence of successful treatment with CPAP. Read More

Nat Sci Sleep 2021 27;13:1495-1506. Epub 2021 Aug 27.

Sleep Center, The Second Affiliated Hospital of Soochow University, Soochow University, Suzhou, 215004, People's Republic of China.

Purpose: To investigate the effect of continuous positive airway pressure (CPAP) on sleep electroencephalogram (EEG) activity in patients with obstructive sleep apnea (OSA) and to examine the correlation between quantitative EEG changes and cognitive function.

Patients And Methods: A total of 69 men and 11 women were collected with an average age of 39.61 ± 7. Read More

Vestn Otorinolaringol 2021 ;86(3):56-60

Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia.

Objective: To assess the severity of daytime sleepiness and the level of sleep apnea/hypopnea index (AHI), as well as the possibility of their correction, in the long-term period after uvulopalatoplasty (UPP) in patients suffering from obesity and obstructive sleep apnea syndrome (OSAS).

Material And Methods: We retrospectively analyzed the data of the patients, who requested a consultation due to nighttime snoring, witnessed sleep apneas and daytime drowsiness. We included men and women of ages 40 to 65 (24 male, 17 female) without cardiac or lung insufficiency. Read More

Cureus 2021 Jun 2;13(6):e15391. Epub 2021 Jun 2.

Emergency Medicine, School of Public Health, University of Michigan, Ann Arbor, USA.

Objectives To evaluate the effectiveness of a new mandibular advancement device (MAD) (Prosomnus® [IA] Sleep Device, Prosomnus Sleep Technologies, Pleasanton CA) fitted with a compliance tracker as a first-line treatment in a population of patients with mild to severe obstructive sleep apnea (OSA). Methods Treatment effectiveness was measured using pre and post-treatment home sleep testing (HST) and validated sleep and quality of life questionnaires. Mean disease alleviation (MDA) was calculated to compare the treatment effectiveness of MAD to historical continuous positive airway pressure (CPAP) effectiveness data. Read More

Afr J Thorac Crit Care Med 2020 13;26(3). Epub 2020 Oct 13.

Department of Pulmonology, University Hospital Yalgado Ouedraogo, Ouagadougou, Burkina Faso.

Background: Obstructive sleep apnoea syndrome (OSAS) is the most common respiratory disorder related to sleep. Its prevalence in developed countries varies from 3% to 28%. In several African countries, including Burkina Faso, this syndrome is still under-diagnosed and goes largely untreated. Read More

Auris Nasus Larynx 2021 Jun 6. Epub 2021 Jun 6.

Department of Otorhinolaryngology, Head and Neck Surgery, Juntendo University School of Medicine, Tokyo, Japan.

Concurrent chemoradiotherapy (CCRT) is one of the most promising treatments for advanced head and neck cancer (HNC). On the other hand, CCRT may induce severe edema in laryngo-pharyngeal structures in association with radiation. This is a report of a 66-year-old man with severe obstructive sleep apnea (OSA) associated with edema in laryngo-hypopharynx after CCRT for advanced laryngeal and hypopharyngeal cancer. Read More

Acta Otorhinolaryngol Ital 2021 Apr;41(2):120-130

Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi (Salerno), Italy.

Medicina (Kaunas) 2021 Apr 1;57(4). Epub 2021 Apr 1.

Clinic of Pneumology and Allergology, Center for Sleep Medicine and Respiratory Care, Institute for Pneumology at the University Witten/Herdecke, 42699 Solingen, Germany.

Obstructive sleep apnea (OSA) syndrome is a multi-factorial disorder. Recently identified pathophysiological contributing factors include airway collapsibility, poor pharyngeal muscle responsiveness, a low arousal threshold, and a high loop gain. Understanding the pathophysiology is of pivotal importance to select the most effective treatment option. Read More

Eur Arch Otorhinolaryngol 2022 Feb 22;279(2):945-953. Epub 2021 Apr 22.

Otorhinolaryngology Department, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt.

Purpose: To assess predictors of success and failure of an updated lateral pharyngoplasty as an independent procedure in treating obstructive sleep apnea with CPAP failures.

Methods: Forty-six patients with known OSAS who were resistant to CPAP or failures were included. BMI, Stop-Bang score, and sleep study data were recorded before and after the updated Cahali pharyngoplasty procedure. Read More

Sleep Med 2021 03 29;79:101-106. Epub 2020 Dec 29.

Division of Pulmonary and Sleep Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.

Objective: The effects of vagus nerve stimulation (VNS) on sleep disordered breathing (SDB) have been reported in limited case series. Detailed studies, particularly in the pediatric population, have not been performed. The primary purpose of this study is to describe clinical characteristics, polysomnographic findings, and management of children treated with VNS. Read More

Respir Physiol Neurobiol 2021 03 25;285:103603. Epub 2020 Dec 25.

Department of Research, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.

Purpose: Resolvin is a checkpoint controller in inflammation. Matrix metalloproteinase-9 (MMP-9) is an airway remodeling regulator. We evaluated the levels of resolvin and MMP-9 protein in the serum and exhaled breath condensate (EBC) before and after continuous positive airway pressure (CPAP) treatment. Read More

Chest 2020 12;158(6):e311-e315

Division of Pulmonary, Critical Care, and Sleep Medicine, Rush University Medical Center, Chicago, IL. Electronic address:

Case Presentation: A 67-year-old woman was evaluated for snoring, frequent awakenings, excessive sleepiness, nocturia, headaches, witnessed apneas, and choking and gasping from sleep. Medical history included OSA, hypertension, type 2 diabetes, depression in remission, and mild intermittent asthma. Epworth sleepiness scale score was 22 (abnormal is ≥10, maximum score is 24; increasing scores represent increasing sleepiness). Read More

Sleep Biol Rhythms 2021 7;19(1):109-110. Epub 2020 Nov 7.

Professor Emeritus, University of Sydney, Sydney, Australia.

Cochrane Database Syst Rev 2020 11 3;11:CD013449. Epub 2020 Nov 3.

Bilbao, Spain.

Background: Obstructive sleep apnoea (OSA) is a syndrome characterised by episodes of apnoea (complete cessation of breathing) or hypopnoea (insufficient breathing) during sleep. Classical symptoms of the disease - such as snoring, unsatisfactory rest and daytime sleepiness - are experienced mainly by men; women report more unspecific symptoms such as low energy or fatigue, tiredness, initial insomnia and morning headaches. OSA is associated with an increased risk of occupational injuries, metabolic diseases, cardiovascular diseases, mortality, and being involved in traffic accidents. Read More

Sleep Breath 2021 Jun 1;25(2):867-876. Epub 2020 Oct 1.

Department of Respiratory Medicine, Zhongshan Hospital, Fudan University, 180 Feng Lin Rd, Shanghai, 200032, China.

Purpose: Obstructive sleep apnea-hypopnea syndrome (OSAHS) is associated with alterations in glucose metabolism. The Berlin questionnaire (BQ) is effective in identifying subjects with high risk of OSAHS. However, its validity in patients with glucose metabolic dysfunction remains unclear. Read More

Auris Nasus Larynx 2021 Jun 8;48(3):339-346. Epub 2020 Sep 8.

Department of Otolaryngology-Head and Neck Surgery, Division of Sleep Surgery, Rush University Medical Center, Chicago, IL, USA; Department of Otolaryngology, Advanced Center for Specialty Care, Advocate Illinois Masonic Medical Center, Chicago, IL, USA.

Continuous positive airway pressure (CPAP) is the primary treatment of obstructive sleep apnea/hypopnea syndrome (OSA). Most sleep physicians are in agreement that a certain number of OSA patients cannot or will not use CPAP. Although other conservative therapies such as oral appliance, sleep hygiene and sleep positioning may help some of these patients, there are many who fail all conservative treatments. Read More

Cureus 2020 Aug 17;12(8):e9796. Epub 2020 Aug 17.

Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.

Obstructive sleep apnea (OSA) is a common condition, and if not treated can be a significant risk factor for multiple comorbidities like hypertension (HTN), coronary artery disease (CAD), and congestive heart failure (CHF). The underlying pathophysiology involves coagulation and inflammatory pathways, including an overactive sympathetic nervous system. This ultimately causes hemodynamic changes and subclinical myocardial injuries. Read More

Heart Lung 2020 Nov - Dec;49(6):940-948. Epub 2020 Aug 13.

Department of Chest Medicine and Sleep Center, Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey.

Background: Inspiratory muscle training (IMT) and oropharyngeal exercises (OE) have different advantages and disadvantages and a comparison of these modalities has been recommended. The aim of this study was to compare the effects of IMT and OE on important outcomes for patients with OSAS.

Methods: This was a randomized controlled clinical trial. Read More

JMIR Res Protoc 2020 Aug 14;9(8):e14786. Epub 2020 Aug 14.

Pulmonary Division-Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina de São Paulo, São Paulo, Brazil.

Background: Mounier-Kuhn syndrome or congenital tracheobronchomegaly is a rare disease characterized by dilation of the trachea and the main bronchi within the thoracic cavity. The predominant signs and symptoms of the disease include coughing, purulent and abundant expectoration, dyspnea, snoring, wheezing, and recurrent respiratory infection. Symptoms of the disease in some patients are believed to be pathological manifestations arising due to resident tracheobronchomalacia. Read More